What Is Medicaid Health Insurance?

The ultimate contradiction of medical care and insurance is that those who are the least likely to have it are the most likely to need it. People with low income are more likely to be in high stress jobs – possibly more than one of them — living in more dangerous conditions, and on a less healthy diet and exercise routine. All of this together is likely to contribute to a myriad of health problems that is unlikely they will be able to afford.

That’s why the national conversation about universal health care is so relevant. Many people feel that the only way to solve the previously explained contradiction is to make free or affordable health care available to people of all income levels. It makes sense to some, and it doesn’t to others. We can debate the merits of this idea all day, and it’s likely some of you already are, but the fact remains: today’s health care is still very expensive.

Some things are changing, though. The Affordable Care Act, affectionately referred to as Obamacare by so many, has put in place, or improved, a number of government programs designed to give people easier access to health care by expanding the availability and benefits of insurance coverage. One such program is Medicaid.

Medicaid is a program run together by both federal and state governments, and is a subset of Medicare. It is designed to help low income individuals and families pay for medical expenses. It was also put in place to help with certain services Medicare fails to cover, like assisted living and nursing homes.

The History of Medicaid
Medicaid was put into existence by the Social Security Amendments of 1965. By adding Title XIX to the Social Security Act, it required that federal government participate in the Medicaid program by providing funds to the state governments to subsidize the program. This put the states in a position where they could help their residents with their health care costs.

There are federal regulations for states that participate in this program, but it is not a requirement that states do in fact participate. Because Medicaid is executed at a state level, the benefits and requirements vary on a state to state basis. These state run programs are overseen by the Centers for Medicare and Medicaid services at a federal level.

Affordable Care Act
After 40 years without significant changes to the Medicaid program, the passage and implementation of the Affordable Care Act in 2010 brought about the first major changes to the program in 2014. The program, which initially was designed for patients making only 100 percent of the Federal Poverty Line or less, was extended to people making up to 133 percent of the Federal Poverty Line. The changes also included making the federal government pay for a larger portion of the program, though, due to a supreme court ruling, these changes have only taken place in a few states.

Do You Qualify for Medicaid?
Medicaid is a program that can be a life saver for many people across the nation. But given that it is a government program, it comes with its complications, especially in eligibility. Luckily, one of the things expanded on by the Affordable Care Act was Medicaid eligibility.

First of all, to qualify for Medicaid you must be a United States Citizen with a Social Security number. You must also be a resident of the state in which you apply for Medicaid. There are also limits on your income, which varies from state to state. Most states will require you make 100 percent of the Federal Poverty Line or less. Beyond that, it gets a little more complicated. You must fall into one of the following categories to be eligible for Medicaid.

Pregnant Women
Medicaid was put in place partially to benefit young or low-income mothers and make their birthing process, as well as the infant years of their child’s life, easier.

The Elderly
People who are 65 years of age or older are eligible for Medicaid if they fit within their state’s income restrictions.

The Blind
Medicaid offers benefits to help individuals that are blind or have low vision as well.

The Disabled
People who are disabled, according to the standards put in place by the Social Security Administration, can benefit from Medicaid.

A Child or Parent of a Child
Both children and those who are legally responsible for children are eligible for Medicaid benefits.

Now you know if you qualify for Medicaid, but how do you actually make it a part of your life? As previously stated, Medicaid is a program run by the federal government in partnership with the states. So that means any application process is going to have multiple steps, and will vary from state to state.

Research
Start by researching the application process in the state in which you will be applying for Medicaid. This can be done through a quick Google search, by visiting Healthcare.gov, or by calling your local Medicaid website.

Acquire Your medical information
You will need to be ready to provide a large amount of information about yourself and your medical past in order to receive Medicaid benefits. You will need basic proof of identity like proof of age, citizenship, and residence. You will also need to verify all sources of income, as well as any other insurance coverage you may have. If you are applying for benefits due to a disability that is verified by the Social Security Administration, you will also need proof of said disability.

Complete and Turn in Your Application
Once gathering all the relevant information and receiving the appropriate forms from your state, all that’s left is to fill out the paper work and submit it. This process can sometimes involve applications in multiple mediums, such as online, paper, and in-person applications.

Complete this process with plenty of time to spare, because your application is not required to be accepted or denied until up to 45 days after its submission. In the case your application is rejected, you also have the right to appeal.

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[…] health coverage year round. The same exception applies for those who qualify for coverage through Medicaid. If you do not meet these criteria, than you must face a qualifying life event, as described below, […]

Rob Schwab – Insurance Agent

Hi, my name is Robert Schwab. I am a licensed insurance agent with extensive training in the Affordable Care Act and healthcare reform. There have been a lot of health insurance changes recently and I consider it my job to help consumers fully understand their insurance policy. Read More…

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